Provider Demographics
NPI:1174693139
Name:SKAGIT HOSPICE SERVICES L L C
Entity type:Organization
Organization Name:SKAGIT HOSPICE SERVICES L L C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-814-5550
Mailing Address - Street 1:227 FREEWAY DR STE A
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2887
Mailing Address - Country:US
Mailing Address - Phone:360-814-5550
Mailing Address - Fax:360-814-5591
Practice Address - Street 1:227 FREEWAY DR
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2805
Practice Address - Country:US
Practice Address - Phone:360-814-5550
Practice Address - Fax:360-814-5591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-437251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3990090Medicaid
WA50-1505Medicare PIN